Advances in Pharmacology and Therapeutics Journal
Volume:3 Issue: 1, Summer 2023

Postoperative pain following laparoscopic cholecystectomy is common in abdominal surgeries. Opioids and non-steroidal anti-inflammatory drugs are used in the management of postoperative pain. The current clinical study was undertaken to evaluate the efficacy of a preemptive diclofenac suppository for the alleviation of post-surgery pain and opioid consumption in laparoscopic cholecystectomy patients.

A total of eighty patients aged 18 to 65 who underwent laparoscopic cholecystectomy in Sina Hospital of Maragheh University of Medical Sciences were included in this prospective, matched case-control study and were randomly allocated to two groups of 40 each. Subjects received 100 mg diclofenac suppository or placebo within 2 h before surgery. The pain score and analgesic consumption data were recorded up to 24 h postoperatively. An Independent t-test was utilized for the analysis of results.

Visual Analogue Scale (VAS) scores in the diclofenac group were statistically lower at 2, 4, 8, and 12 hours compared to the placebo-controlled group. Opioid consumption was statistically significantly reduced in the treatment group compared to the control group (20.0 ± 3.48 vs 54.7 ± 3.63 ml, respectively. Rescue analgesia usage was significantly higher in the control group. Half of the patients in the diclofenac group did not need any opioid drug. Besides, postoperative side effects and hospital staying duration were decreased in the diclofenac group in comparison to the control group.

Current study demonstrates that preemptive diclofenac 100 mg administration could be taken into consideration to alleviate postoperative pain and is a valuable addition to the standard treatment following cholecystectomy pain management.

Scopolamine has frequently been reported to induce a “memory deficit” in animals and humans. However, the possible role of the non-cognitive effects of the drug in these impairments is often ignored. In the present study, the effects of scopolamine on various behaviors in the radial arm maze were recorded and the ability of physostigmine to reverse them was examined. Male Long-Evans hooded rats were trained on an 8-arm radial maze to consume drops of 0.1 ml of sweetened milk from the end of each arm. Once the asymptomatic performance was achieved, the effects of scopolamine (0.25 mg/kg i.p. 20 min before testing) on(1) the number of errors (re-entries into the arms), (2) the number of rewards drops not consumed, and (3) agitation were examined. The number of errors, the number of drops left, and agitation scores were increased significantly compared to saline-treated rats. Concomitant administration of scopolamine and physostigmine (0.25 i.p. 15 min before testing) significantly reduced the agitation scores and revealed a trend toward a decrease in the number of drops left compared to scop-treated rats. However, in this experiment, scopolamine did not significantly increase the number of errors compared to the saline-treated rats. Taken together, scopolamine induced a small but inconsistent increase in the number of errors. In contrast, there were significant effects of scopolamine on agitation and milk consumption in both experiments. These non-cognitive effects of scopolamine (which were attenuated by physostigmine) may indirectly lead to an increase in errors.

COVID-19 treatment is still essential especially manage patients suffering from severe conditions. Many pharmaceutical drugs like Hydroxychloroquine, Oseltamivir, and others were introduced for curing these patients, but further, than their efficacy, some side effects might be seen. Some patients might not respond to these drugs, and their condition did not heal. This study described a 78-year-old man who suffered from severe COVID-19. His first complication in the first two days was progressive persistent dry cough and Sore throat, and on the third-day fever, chills, weakness, lethargy, and severe loss of appetite. He did not properly respond to chemical drugs, and his condition did not get better. improving the condition Finally, he was treated with Persian Medicine (Iranian traditional medicine; ITM) prescription. The advice of the Persian Medicine (PM) specialist was to contain pomegranate paste, almonds, wheat semolina soup, cooked quince, and pineapple. After two weeks and a month of follow-up, he did not show any complications. According to the data from the treatment period and changing the patient's signs and symptoms, the probable potency of PM for treating COVID-19 alone or as a supplementary prescription could be concluded. Based on the review of the literatures about the efficacy of various traditional medicine, it could be concluded that further studies are necessary to prove the efficacy of PM for COVID-19 and other viral infections. Also, the importance of patient follow-up and frequent visits should be observing patients' condition to control and revise the advice.

Violet-almond oil (VAO) as a widely used remedy with various healing properties in traditional Persian Medicine (PM), suffers from a lack of standardization parameters. This study intended to determine some physicochemical and phytochemical characteristics of VAO. Organoleptic properties (including color, smell, turbidity, appearance, and viscosity) were determined by sensory evaluation. Specific gravity, refractive index, acid value, saponification value, fatty acid profile, and amino acid profile were determined by appropriate methods. The total phenolic content and microbial load also were measured. It was characterized as a light yellow and thin oil with a mild odor, density of 0.91 g/ml, a refractive index of 1.470, acidity index of 1.66, and saponification value of 189.61. Total phenol and flavonoid contents based on Gallic acid and Routine were 0.014 and 0.048 mg/ml, respectively. Its main fatty acids were linoleic acid, palmitic acid, stearic acid, and oleic acid. Glutamine and ornithine were the most abundant amino acids, respectively. The general characteristics obtained may provide preliminary data for the standardization of this valuable traditional remedy.

Mental problems caused by opioid addiction or drug withdrawal can increase the risk of relapse in methadone maintenance treatment. The present study was conducted to compare the efficacy of acceptance and commitment therapy enriched with compassion-focused therapy on the effect of sertraline and venlafaxine on patients' psychological distress under methadone maintenance treatment. This study was a clinical trial with a pre-test and post-test design. Forty patients under methadone maintenance treatment were selected by voluntary sampling and randomly divided into two groups. The first group received acceptance and commitment therapy enriched with compassion-focused therapy and venlafaxine, and the second group received acceptance and commitment therapy enriched with compassion-focused therapy and sertraline for intervention days. The patients were evaluated based on the anxiety, stress, and depression questionnaire. The data were analyzed using the paired t-test and analysis of covariance at a significance level of 0.01. Both venlafaxine, and sertraline plus acceptance and commitment therapy enriched with compassion-focused therapy, were influential on psychological distress and its dimensions (depression, anxiety, and stress) (P<0.001). Sertraline had a more significant effect on psychological distress, and anxiety than venlafaxine (P<0.01). No significant difference was observed between them on depression and stress (p>0.05). Sertraline is more effective than Venlafaxine in controlling psychological symptoms in methadone maintenance treatment.

Thymol has an antiprotozoal effect. Nanoparticulate systems are useful carriers for both small and large drug molecules, which can protect them from some chemical and biological damages as well as target drug delivery to specific organs or receptors. In this work, the nano-liposomal system and solid lipid nanoparticles loaded by thymol were prepared and the effectiveness of them were evaluated on Leishmania major promastigotes. Several formulations of nano-liposomes and solid lipid nanoparticles were prepared, and the amount of thymol loading, in-vitro release profile, particle size, and zeta potential were evaluated. Finally, the best formulations were serially diluted and incubated for 24, 48, and 72 hours on Leishmania major promastigotes, which cultured on Novy–MacNeal–Nicolle medium, and the results were analyzed. The highest loading of thymol in nano-liposomes (92%) was seen in the formulations made with phosphatidylcholine (Called L3), and among the solid lipid nanoparticles, the formulation prepared with glycerol monostearate (S1) had the most entrapment efficiency of thymol (87%). These formulations were selected to evaluate the release rate of thymol. The results showed that S1 has a slower release rate than L3; this may be due to the presence of Glycerol monostearate in solid lipid nanoparticles structure. The best formulations, L3 and S1, were chosen for anti-Leishmaniosis assessment; which showed that all three forms of free thymol, nanoliposomes, and solid lipid nanoparticles inhibited Leishmania major. The half maximal inhibitory concentration (IC50) of free thymol, nanoliposome, and solid lipid nanoparticles for a 24-hour incubation are 7.8, 62.5, and 125, respectively, which decrease to 7.8, 7.8, and 15.6 for 48 hours and 7.8, 0.49, and 0 for 72 hours of incubation. Thymol has a significant effect on the inhibition of Leishmania major promastigotes and usage of thymol in the form of liposomes or solid lipid nanoparticles can sustain the drug release and have a lower IC50 during the longer incubation time.

Remdesivir (RDV) has been considered a “molecule of hope” for the treatment of COVID-19. Existing literatures show some inconsistent results about its efficacy in clinical settings.  The trial results showed that RDV treatment was associated with improved recovery time in hospitalized adult patients who experienced infection of the lower respiratory system. A Spanish study showed that in patients who had less than one week of symptoms before hospitalization, RDV reduced the risk of death. A meta-analysis showed that RDV is beneficial in reducing mortality in hospitalized patients who needed no or conventional oxygen support. Its role in the treatment of ventilated patients was underpowered. Another systematic review demonstrated that RDV may have some benefits in the clinical period of the disease in hospitals and outpatient settings but the certainty of the evidence is limited.